Integrating Collaborative Learning, Artistic Mediation, and AI to Enhance Midwifery Clinical Reasoning Based on the NANDA–NIC–NOC Framework

Background: Clinical reasoning is a core midwifery competency, yet adopting standardized NANDA–NIC–NOC frameworks remains challenging due to perceived abstraction. Objective: To explore the effectiveness of a pedagogical intervention combining collaborative learning, artistic mediation, and AI to enhance midwives’ clinical reasoning. Methods: A convergent parallel mixed-methods study with 40 practicing midwives at Hassan I Hospital, Morocco, involving a structured workshop with a learning game, symbolic tree creation, and AI-facilitated reflection. Inductive thematic analysis was applied to qualitative data, complemented by descriptive pre/post rubric scores assessed by two independent raters. Results: Four themes emerged: (1) improved structuring of clinical reasoning; (2) deeper conceptual appropriation of the NANDA–NIC–NOC framework; (3) enhanced reflexivity and metacognition via AI; (4) high engagement and pedagogical acceptability. Conclusions: Integrating collaborative gaming, artistic mediation, and AI showed high pedagogical acceptability and supported immediate structuring of clinical reasoning in midwifery, offering a promising and feasible model for initial and continuing training in resource-limited settings. Longitudinal studies are needed to confirm long-term clinical impact. Clinical reasoning; NANDA–NIC–NOC; artificial intelligence; simulation-based learning; collaborative learning; educational innovation.